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Organization
EASTERN IOWA THERAPEUTICS PC
Active
Organization
EASTERN IOWA THERAPEUTICS PC
Active
Other names
Athletico Ltd
Organization subpart
No
Provider details
NPI number
Authorized official
JUANA FERNANDEZ (CREDENTIALING MANAGER)
(630) 575-1980
Entity
Organization
Contact information
Practice address
5300 FOUNTAINS DR NE, SUITE 106, CEDAR RAPIDS, IA 52411-6607
(319) 378-6958
(319) 378-6938
Mailing address
5300 FOUNTAINS DR NE, SUITE 106, CEDAR RAPIDS, IA 52411-6607
(319) 378-6958
(319) 378-6938
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
NULL
225100000X
Physical Therapist
Primary
—
—
225X00000X
Occupational Therapist
—
NULL
225X00000X
Occupational Therapist
—
—
Other
Enumeration date
07/29/2015
Last updated
07/29/2015
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